POS1234 CEREBROVASCULAR AND CARDIOVASCULAR RISK OF PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES IS INCREASED AND CAN BE PREDICTED BY ENA POSITIVITY
Authors: K. Triantafyllias, S. Gauch, L. Cavagna, A. Schwarting
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with idiopathic inflammatory myopathies (IIM) are under increased cardiovascular (CV) and cerebrovascular (CVB) risk [1-3]. Nevertheless, data on diagnostic tools that could assist CV and CVB patient screening in IIM are scarce. Surrogate markers of CV and CVB risk have been shown to improve risk stratification in the general population and have thus been endorsed by the European Society of Cardiology (ESC) for use in clinical practice. In particular, stiffness of the aortic vasculature and sonography of the carotid arteries are associated with high levels of evidence regarding their CV- and CVB-risk predicting value. <h3>Objectives</h3> Therefore, aim of this study was to examine an oscillometric marker of aortic stiffness and sonographic indices of carotid atherosclerosis and rigidity in a cohort of IIM patients. Moreover, we sought to investigate their relationships with patient- and disease-associated parameters. <h3>Methods</h3> Patients from two large Rheumatology Departments, who have been diagnosed with IIM according to the ACR/EULAR criteria, were recruited. Carotid-femoral pulse wave velocity (cfPWV; gold standard) was used for the examination of aortic stiffness. Moreover, B-mode and Doppler sonography examinations of the common- and internal carotid arteries (CCA, ICA) were performed to assess plaque presence and/or possible abnormalities of carotid intima media thickness (cIMT), as well as vascular resistance and pulsatility indices (RI, PI). The ESC-SCORE (Systematic Coronary Risk Evaluation) was also assessed in all eligible patients. <h3>Results</h3> 73 IIM patients [58.9%♀; age 58 (50-65, IQR)] and 88 healthy subjects [84.1%♀; age 51 (37-57, IQR)] underwent cfPWV examinations in the context of the study (Table 1). A subgroup of the patients (n=63) was additionally evaluated via carotid sonography. IIM patients showed statistically significantly higher cfPWV- [7.92 m/s (6.49-9.26, IQR), vs. 6.72 m/s (6.0-7.69, IQR); p&lt;0.001] and cIMT-values [0.92 mm (0.77-1.1, IQR), vs. 0.8 mm (0.66-0.88, IQR); p&lt;0.001], compared to controls. CCA- and ICA- resistance and pulsatility indices were also statistically significantly higher in the patient group (all; p&lt;0.01). Almost all of these differences remained significant after adjusting for confounding factors, such as age, smoking, BMI, hypertensive treatment and cholesterol [cIMT (p<sub>adj</sub>&lt;0.001), CCA-PI (p<sub>adj</sub>=0.002), CCA-RI (p<sub>adj</sub>=0.004), ICA-PI (p<sub>adj</sub>=0.02), ICA-PI (p<sub>adj</sub>&lt;0.001)]. Interestingly, patients with ENA positivity showed higher CCA-RI values compared to their counterparts [0.85 (0.765-0.88, IQR) vs. 0.77 (0.72-0.82, IQR), p=0.044]. <h3>Conclusion</h3> Hereby, we could show that IIM patients have a higher level of carotid atherosclerosis, as well as increased vascular resistance and pulsatility, compared to healthy subjects. Thus, a higher CVB and CV risk can be postulated. To our knowledge, this is one of the largest surrogate marker studies in the field of IIM and the first one to show that positivity of myositis associated antibodies (MSA) can be an independent predictor of a higher carotid resistance index. Therefore, MSA-status should be taken into account during CV/CVB risk-stratification of IIM. <h3>References</h3> [1]Diederichsen, L P, et al. Curr Opin Rheumatol 2017;29(6):598-603. [2]Triantafyllias K, et al. Rheumatology (Oxford) 2021;60(3):1300-131 [3]Rai S K, et al. Rheumatology (Oxford) 2016;55(3):461-9. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Konstantinos Triantafyllias Speakers bureau: Pfizer, Novartis, Galapagos, Janssen, Chugai, Sanofi, AbbVie, Svea Gauch: None declared, Lorenzo Cavagna: None declared, Andreas Schwarting Speakers bureau: GSK, Novartis, Grant/research support from: GSK, Pfizer, AbbVie, Novartis, and Roche.